One widely held view of prenatal screening is that its foremost aim is, or should be, to enable reproductive choice; this is the Pure Choice view. The article critiques this position by comparing it with an alternative: Public Health Pluralism. It is argued that there are good reasons to prefer the latter, including the following. Public Health Pluralism does not, as is often supposed, render PNS more vulnerable to eugenics-objections. The Pure Choice view, if followed through to its logical conclusions, (...) may have unpalatable implications, such as extending choice well beyond health screening. Any sensible version of Public Health Pluralism will be capable of taking on board the moral seriousness of abortion and will advocate, where practicable, alternative means of reducing the prevalence of disease and disability. Public Health Pluralism is at least as well-equipped as the Pure Choice model to deal with autonomy and consent issues. (shrink)

To what extent should parents be allowed to use reproductive technologies to determine the characteristics of their future children? Is there something morally wrong with choosing what their sex will be, or with trying to 'screen out' as much disease and disability as possible before birth? Stephen Wilkinson offers answers to such questions.

This article provides a critical assessment of some aspects of Ann Kerr and Tom Shakespeare's Genetic Politics: from eugenics to genome. In particular, I evaluate their claims: (a) that bioethics is too ‘top down’, involving normative prescriptions, whereas it should instead be ‘bottom up’ and grounded in social science; and (b) that contemporary bioethics has not dealt particularly well with people's moral concerns about eugenics. I conclude that several of Kerr and Shakespeare's criticisms are well-founded and serve as valuable reminders (...) to the bioethics community. These include the claims: that bioethics ought not to consist entirely of applying moral theory to cases; that bioethics must take account of relevant empirical evidence; and that bioethicists should be on the look out for those subtle social forces which can undermine the voluntariness of people's choices and consents. However, we should reject some of Kerr and Shakespeare's other criticisms and I conclude (amongst other things) that even ‘mainstream’ bioethics is better able to deal with difficult issues like eugenics than Kerr and Shakespeare suggest. (shrink)

This article provides a critical assessment of some aspects of Ann Kerr and Tom Shakespeare's Genetic Politics: from eugenics to genome. In particular, I evaluate their claims: (a) that bioethics is too ‘top down’, involving normative prescriptions, whereas it should instead be ‘bottom up’ and grounded in social science; and (b) that contemporary bioethics has not dealt particularly well with people's moral concerns about eugenics. I conclude that several of Kerr and Shakespeare's criticisms are well-founded and serve as valuable reminders (...) to the bioethics community. These include the claims: that bioethics ought not to consist entirely of applying moral theory to cases; that bioethics must take account of relevant empirical evidence; and that bioethicists should be on the look out for those subtle social forces which can undermine the voluntariness of people's choices and consents. However, we should reject some of Kerr and Shakespeare's other criticisms and I conclude (amongst other things) that even ‘mainstream’ bioethics is better able to deal with difficult issues like eugenics than Kerr and Shakespeare suggest. (shrink)

When the benefits of surgery do not outweigh the harms or where they do not clearly do so, surgical interventions become morally contested. Cutting to the Core examines a number of such surgeries, including infant male circumcision and cutting the genitals of female children, the separation of conjoined twins, surgical sex assignment of intersex children and the surgical re-assignment of transsexuals, limb and face transplantation, cosmetic surgery, and placebo surgery.

Preimplantation genetic diagnosis and some prenatal screening programmes have been criticized for being 'eugenic'. This paper aims to analyse this criticism and to evaluate one of the main ethical arguments lying behind it. It starts with a discussion of the meaning of the term 'eugenics' and of some relevant distinctions: for example, that between objections to eugenic ends and objections to certain means of achieving them. Next, a particular argument against using preimplantation genetic diagnosis to 'screen out' disability is considered, (...) one based on the Equal Value Principle, which says that we should value disability and non-disability equally. It is argued that present practice and policy probably do violate the Equal Value Principle, but that this principle is itself unsound. (shrink)

It is argued that there are good reasons for believing that commercial surrogacy is often exploitative. However, even if we accept this, the exploitation argument for prohibiting (or otherwise legislatively discouraging) commercial surrogacy remains quite weak. One reason for this is that prohibition may well 'backfire' and lead to potential surrogates having to do other things that are more exploitative and/or more harmful than paid surrogacy. It is concluded, therefore, that those who oppose exploitation should concentrate on: (a) improving the (...) conditions under which paid surrogates 'work'; and (b) changing the background conditions (in particular, the unequal distribution of power and wealth) which generate exploitative relationships. (edited). (shrink)

The commercial trading of human organs, along withvarious related activities (for example, advertising)was criminalised throughout Great Britain under theHuman Organ Transplants Act 1989.This paper critically assesses one type of argumentfor this, and similar, legal prohibitions:commodification arguments.Firstly, the term `commodification' is analysed. Thiscan be used to refer to either social practices or toattitudes. Commodification arguments rely on thesecond sense and are based on the idea that having acommodifying attitude to certain classes of thing(e.g. bodies or persons) is wrong. The commodifyingattitude consists (...) of three main elements: denial ofsubjectivity, instrumentality, and fungibility.Secondly, in the light of this analysis, the claimthat organ sale involves commodifying the human bodyis examined. This claim is found to be plausible butinsufficient to ground an argument against organ sale,because the very same commodifying attitude is likelyto be present in cases of (unpaid) organ donation. Itis also argued that commodifying bodies per semay not be wrong.Thirdly, the view that organ sale involvescommodifying persons is examined. Although this andthe claim that it is wrong to commodify persons areprobably true, there is â it is argued â littlereason to regard organ sale as worse in this respectthan other widely accepted practices, such as thebuying and selling of labour.The conclusion is that although commodification is auseful ethical concept and although commodificationarguments may sometimes be successful, thecommodification argument against organ sale is notpersuasive. This is not to say, though, that thereare no arguments for prohibition â simply that thisparticular justificatory strategy is flawed. (shrink)